Senior UM Audit & Compliance Lead - Remote

Integra Partners; Phoenix (AZ); À distance; USD 77 000 - 104 000; Plein temps

Avantages offerts par ce poste

Competitive compensation and annualBON

401(k) retirement program with company

Company-paid life insurance

Medical, Vision, and Dental benefits

Paid Time Off (PTO)

Parental Leave

Remote opportunities

Résumé du poste

Integra Partners is seeking a Senior Utilization Management Audit & Compliance Analyst to lead external audits, validate findings, and prepare professional responses. You will partner with operations and IT to drive corrective actions and improve processes across UM functions.

The role emphasizes data analysis, CMS/NCQA regulatory alignment, and audit readiness with opportunities to influence organizational performance. Remote opportunities are available.

Qualifications

• Bachelor’s degree in healthcare administration, public health, or related field preferred.
• 5–10 years of healthcare operations, UM, and/or audit support experience.
• Strong organizational skills and ability to manage multiple deadlines.
• Excellent written and verbal communication with attention to detail.

Responsabilités

• Serve as the primary lead for external audits and oversight reviews.
• Review audit findings, inquiries, and corrective action requests from plans and regulators.
• Conduct investigations to validate findings and determine root causes.
• Gather documentation from UM systems and operations teams.
• Draft clear responses to audit findings and develop corrective actions.
• Ensure timely completion of audit responses and support meetings.
• Track issues and recommend process improvements.
• Assist in implementing and monitoring corrective action plans.
• Support data analysis and reporting for UM performance metrics.

Connaissances

Audit leadership

Data validation

Regulatory compliance

Root cause analysis

Customer audit responses

Process improvement

Formation

Bachelor’s degree in healthcare administration, public health, or related field

Outils

Essette

Description du poste

Integra Partners is seeking a Senior Utilization Management Audit & Compliance Analyst to lead external audits, validate findings, and prepare professional responses. You will partner with operations and IT to drive corrective actions and improve processes across UM functions.

The role emphasizes data analysis, CMS/NCQA regulatory alignment, and audit readiness with opportunities to influence organizational performance. Remote opportunities are available.